| NPI | 1497195242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: HI MD-24159) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA MD61155134) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2025-03-06 |